14D2033328 CLIA NUMBER - DANVILLE HOME TRAINING

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Laboratory Demographics

CLIA Number: 14D2033328

Facility Name: DANVILLE HOME TRAINING

Facility Address:
3 POLAND RD
DANVILLE, IL
ZIP 61834
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Facility Phone Number: 217 446-0583

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1144504549

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	14D2033328
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	DANVILLE HOME TRAINING
Street	3 POLAND RD
City	DANVILLE
State	IL
ZIP	61834
Phone	217 446-0583
CertificateType	4
CertificateEffectiveDate	11/30/2023
CertificateExpirationDate	11/29/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024